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In its promotion of an autonomy model of decision-making in medical matters, French law, after making patients’ consent to medical procedures compulsory by case law then by legislation, established the primacy of the expression of patients’ wishes. Lawmakers followed the principle of shared medical decision-making and, for situations in which subjects are not fit to express their wishes, created mechanisms to represent their wishes as expressed previously. Examination of comparable legal provisions in other countries raises questions about the pertinence of the French model, which has not fully incorporated the concept of decision-making capacity but limited itself to a binary appreciation of fitness to express one’s wishes.

The Primacy of the Patient’s Wishes in the Medical Decision-making Procedure Established by French Law